Sole ContractApplication Form

If you are a joint contract holder and want to apply to be a sole contract holder you need to complete the application form below. The person leaving your property will also need to give us one months’ notice to withdraw from the contract. Once we’ve received both your application and the ‘Withdraw from contract’ form, your community housing officer will investigate and contact you as soon as possible with a decision.

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Name *

First

Last

Community Manager *

Area *

Guidance

If you wish to apply for a sole contract then this form needs to be completed. Upon receipt of this application we will carry out the necessary investigations to determine if your request for a sole contract can be approved.

Please note that a joint contract must be brought to an end by way of one months' notice from one or both contract holders before we can consider an application for a sole contract. This can be completed by signing the Notice to withdraw from contract form (see below).

Applicants Details:

Joint Contract Address: *

City *

ZIP Code *

Name of Person seeking sole contract: *

Name *

First

Last

Please enter the name of person seeking sole contract

Date of Birth: *

National Insurance Number: *

Ethnicity *

Phone *

Email Address: *

Contact preferences: *

Phone
Email
Letter
Face to face

Please select all that apply.

Please specify any medical condition you, or the occupants wishing to remain, have: *

If you have children, are they subject to a court order? *

Property details:

Property Type: *

No. of bedrooms: *

Any adaptations in property: *

Details of contract holder seeking to terminate the contract:

Name: *

Date of birth: *

National Insurance Number: *

Forwarding address: *

City *

ZIP Code *

Ethnicity: *

Telephone number: *

Date you intend to move out/ intend to move out: *

Reason for leaving: *

Please list any other considerations that you would like us to take into account when assessing the sole contract application:

Declarations

It is advisable for you to obtain independent legal advice in relation to any changes that you wish to make to your contract.

USE OF PERSONAL INFORMATION:

By signing this form, both parties are agreeing for Bron Afon Community Housing to store and share the information you have provided with any relevant partners as part of the assessment process. You are also confirming that all information provided is correct to the best of your knowledge. Any false statements made may result in Bron Afon taking legal action.

DECLARATION BY CONTRACT HOLDER SEEKING SOLE CONTRACT:

If my application for sole contract is successful I understand that I will be solely responsible for ensuring all of the contract obligations are adhered too. This includes the responsibility of the current condition of the property (including the responsibility to rectify any damage or contract holder own improvements should you later vacate) and for the payment of rent, including any rent arrears.

Print Name: *

Signature *

Clear Signature

Date: *

DECLARATION BY CONTRACT HOLDER SEEKING CONTRACT TERMINATION:

I herby give one months' notice to terminate the current joint contract at

Print Name: *

Signature *

Clear Signature

Date *